Orthopedics

Oct 24, 2022
Why Medical Clearance Is Really a Preoperative Evaluation
Debra Davidson, MJ, CPHRM, Senior Patient Safety Risk Manager, The Doctors Company, and David L. Feldman, MD, MBA, FACS, Chief Medical Officer, The Doctors Company and TDC Group; Senior Vice President, Healthcare Risk Advisors
The goals of the preoperative evaluation are to determine the patient's level of risk and to identify opportunities to mitigate it.

Oct 18, 2022
Moderate or Conscious Sedation in the Office Setting
Julie Brightwell, JD, RN, Director, Healthcare System Patient Safety, Department of Patient Safety and Risk Management
Prevent patient injury when providing moderate sedation in the office by incorporating these patient safety and practice improvement strategies.

Aug 26, 2022
Hip and Knee Replacements: An Examination of Malpractice Claims Against Orthopedic Surgeons From the Ambulatory and Inpatient Settings
Jacqueline Ross, RN, PhD, Coding Director, Department of Patient Safety and Risk Management
The literature related to malpractice claims comparing inpatient and ambulatory knee and hip replacements has so far been limited. Therefore, the purpose of this novel study was to explore potential differences between the two settings in malpractice claims for surgery.

Mar 01, 2022
With Medical Implants, Hope and Plan for the Best, but Talk About the Worst
David L. Feldman, MD, MBA, FACS, Chief Medical Officer, The Doctors Company and TDC Group; Senior Vice President, Healthcare Risk Advisors
Even with common implant procedures, variability among human systems creates risks and uncertainties. Dr. David L. Feldman discusses the importance of a true informed consent process using shared decision making.
From The Doctor’s Advocate

Professional Education
Orthopedic Surgery: Navigating the Risks
According to the MPL Association's recent study, the average indemnity payment for an orthopedic surgery claim is $346,336. Closed claims data from The Doctors Company and the MPL Association involving allegations against orthopedic surgeons were analyzed to gain insight and knowledge for reducing malpractice risk. Common trends and top contributing factors are revealed.
0.8 credit

Oct 26, 2021
Identifying Malpractice Risks for Surgical Practices
Kim Hathaway, MSN, CPHRM, Patient Safety Healthcare Quality and Risk Management Consultant, The Doctors Company
Factors contributing to surgical claims are often related to assessment, communication, and documentation. Surgeons can improve outcomes by evaluating their supporting systems in the office and the locations where they operate.

Professional Education
Patient Safety in Spine Surgery
Spine surgery requires a series of best practice patient safety interventions to reduce the frequency and severity of patient harm while giving the care team the resources to mitigate such harm. Evidence-based clinical methods, pathways, and tools coupled with an evolving culture of patient safety through effective communication, teams, and teamwork has shown to reduce patient harm exponentially. Patient and clinical team experiences are enhanced while ensuring a learning culture is built that approaches surgery from both a technical and nontechnical approach alike.
1.3 credits

Apr 02, 2021
Pre-Procedural Screening and Testing During COVID-19
Throughout the pandemic, surgeons have faced many challenges in adapting to new situations. Now that facilities have resumed elective surgeries, surgeons are facing additional challenges in evaluating and scheduling patients who have recovered from COVID-19. The strategies highlighted here can help ensure a consistent approach in keeping both patients and providers safe.

Mar 23, 2021
Prescribing Opioids Safely: How to Have Difficult Patient Conversations
Roneet Lev, MD, Chief of Scripps Mercy Emergency Department, Chair of Prescription Drug Abuse Medical Task Force, and President of Independent Emergency Physicians Consortium
Drug overdose is the leading cause of accidental death in the U.S., and opioids account for over 60 percent of those deaths. Building a strong doctor-patient rapport can help facilitate tough conversations with patients about opioid prescriptions and reduce risks that could lead to malpractice suits.

Feb 26, 2021
Resources for Elective Procedures During COVID-19
Kim Hathaway, MSN, CPHRM, Patient Safety Healthcare Quality and Risk Management Consultant, and Julie Ritzman, MBA, CPHRM, Vice President, Department of Patient Safety and Risk Management
Your patients most likely want to know about the safety of surgery during the pandemic and what occurs if they contract COVID-19 post-procedure. You may have questions about keeping your staff and patients safe, informing patients about new risks the pandemic has created, and potential liability risks you may be facing.

Professional Education
TeamSTEPPS® Teamwork Training in the Office Practice
This course provides an overview of the evidence-based TeamSTEPPS® concepts, tools, and strategies based on the four areas of 1) leadership, 2) mutual support, 3) situation monitoring, and 4) communication. TeamSTEPPS training provides teachable/learnable skills that improve communication and teamwork among healthcare professionals in both acute care and ambulatory care environments.
1.5 credits

Dec 23, 2020
Podiatry: Lessons from Malpractice Claims
Carol Murray, RHIA, CPHRM, Senior Patient Safety Risk Manager, The Doctors Company
We analyzed 162 podiatric claims to identify top allegations and factors contributing to patient injury.

Dec 23, 2020
Orthopedics Case Study: The Danger of EHR Templates
Robin L. Wessels, MBA, RN, Assistant Vice President, Department of Patient Safety and Risk Management, The Doctors Company
This example of an orthopedic claim involving accurate medical record documentation illustrates the importance of exercising caution when using EHR templates.

Dec 02, 2020
The Role of Pretest Probability in the Evaluation of Suspected Venous Thromboembolism
Howard Marcus, MD, FACP
The presenting signs and symptoms of venous thromboembolism are often vague and nonspecific, and early diagnosis—often crucial to the patient’s outcome—may be challenging.
From The Doctor’s Advocate

Professional Education
Spotlight on Diagnosing PE/DVT
The overall incidence of venous thromboembolism (VTE) —including both deep vein thrombosis (DVT) and pulmonary embolism (PE) —is one case per 1000 patient years. Accurate and timely diagnosis of VTE can be improved with the use of diagnostic guidelines such as Wells criteria and scoring for both DVT and PE.
0.5 credit

Oct 05, 2020
Orthopedics: Informed Consent
Robert Morton, CPHRM, CPPS, Assistant Vice President, Department of Patient Safety and Risk Management, and Dana Faber, MS PSL, RN, Senior Patient Safety Risk Manager, Department of Patient Safety and Risk Management
Inadequate informed consent communication between the surgeon and the patient/family is a top factor contributing to claims against orthopedists.

Professional Education
Cauda Equina Syndrome: A Failure to Diagnose
Failures of systems often prevent physicians from making timely diagnoses. Failures may result when patient assessments are incomplete, having a narrow diagnostic focus, or diagnostic test issues. Other factors that hinder timely diagnoses include failure to appreciate signs and symptoms, lack of consults, and failure to respond to repeated patient concerns/symptoms.
0.5 credit

Aug 25, 2020
Distracting Devices in Healthcare: Malpractice Implications
Shelley Rizzo, MSN, CPHRM, Senior Patient Safety Risk Manager, The Doctors Company
Digital distraction in healthcare is a threat to patient safety and physician well-being. Personal electronic devices can create a digital distraction so engaging that it consumes awareness, potentially preventing healthcare providers from focusing on the primary task at hand—caring for and interacting with patients.

Professional Education
Making an Informed Consent an Informed Choice: Training for Healthcare Professionals
This activity, designed for doctors, nurses, and other providers, examines problems with the process of healthcare informed consent. It describes the principles of informed consent and highlights the benefits gained from a good informed consent process.
2.3 credits

May 13, 2020
Physical Medicine and Rehabilitation Malpractice Claims: Lessons Learned
Michelle Swift, JD, RN, Senior Patient Safety Risk Manager, Department of Patient Safety and Risk Management
We analyzed closed physical medicine and rehabilitation claims to better understand what motivates allegations of injury.

Dec 12, 2019
Making Further Advancements in Anesthesia Care Safety
Susan K. Palmer, MD; Darrell Ranum, JD, CPHRM, Vice President, Patient Safety and Risk Management; and Susan Shepard, MSN, RN, Senior Director, Patient Safety and Risk Management Education
We analyzed 459 claims for new trends in anesthesia care.
From The Doctor’s Advocate

Sep 05, 2019
Advanced Practice Provider Closed Claims: What Can We Learn?
Howard Marcus, MD, FACP, and Susan Shepard, MSN, RN, Senior Director, Patient Safety Staff Education
Top allegations in our claims analysis involving advanced practice providers centered on diagnosis.
From The Doctor’s Advocate

Mar 20, 2019
Study of Malpractice Claims Involving Children
Darrell Ranum, JD, CPHRM, Vice President, Patient Safety and Risk Management
The Doctors Company analyzed 1,215 claims filed on behalf of pediatric patients that closed from 2008 through 2017. The study is based on the claims filed against physicians in 52 specialties and subspecialties and includes an overview of the most common types of claims, expert insights into the specific elements that led to patient injury, and risk mitigation strategies.

Video Mar 21, 2018
What to Expect from Litigation: Dr. Wuest's Perspective
Thomas K. Wuest, MD, MMM, an orthopedic trauma surgeon in Eugene, Oregon, describes his experience defending himself against a medical malpractice suit involving a man who fell over 20 feet from a utility pole and sustained multiple injuries.

Video Oct 03, 2017
Orthopaedic Trauma Surgery: Innovations in Patient Safety
Douglas W. Lundy, MD, MBA, an orthopedic trauma surgeon at Resurgens Orthopaedics in Atlanta, Georgia, describes changes his practice made to improve patient safety based on the data and recommendations in The Doctors Company’s Orthopedics Closed Claims Study. The study revealed that most claims against orthopedists do not reflect the quality of care, but the patient’s perception of the care. Many lawsuits stem from known complications of the procedure.

Video Jun 13, 2017
Orthopaedics: Innovations in Patient Safety
Ralph A. Gambardella, MD, an orthopedic surgery and sports medicine specialist with the Kerlan Jobe Orthopaedic Clinic in Los Angeles, California, describes changes his practice made to improve patient safety based on the data and recommendations in The Doctors Company’s Orthopedics Closed Claims Study. Patient behaviors are a factor in over one-third of orthopedic claims.

Aug 26, 2015
Orthopedics Closed Claims Study
The study of 1,895 orthopedics malpractice claims identified the most common patient allegations and the specific factors contributing to patient injury.